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Jeppesen E, Schmidt AA, Skjødt CK, Hybschmann J, Gjærde LK, Thestrup J, Hansson H, Sørensen JL. Educational programmes for paediatric healthcare professionals in patient- and family-centred care. A scoping review. Eur J Pediatr 2024; 183:2015-2028. [PMID: 38430279 PMCID: PMC11035470 DOI: 10.1007/s00431-024-05455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/05/2024] [Accepted: 01/25/2024] [Indexed: 03/03/2024]
Abstract
To identify and describe educational programmes in patient- and family-centred care for paediatric healthcare professionals. This scoping review was conducted and reported according to the JBI Manual for Evidence Synthesis and the PRISMA guideline. The databases searched included MEDLINE (PubMed), PsycINFO, CINAHL, Scopus, Cochrane, and Embase. Inclusion criteria were experimental, observational and qualitative studies about educational programmes on patient- and family-centred care for paediatric healthcare professionals. Exclusion criteria were reviews and non-peer-reviewed literature. Two reviewers independently screened and extracted the data using Covidence. Of the 13922 records identified, 49 articles met the inclusion criteria. There was a large variety of educational programmes, half of which were interdisciplinary, that mainly targeted nurses and doctors. The median number of participants was 51 (range 7 to 1411). The predominant target population was children with chronic disabilities and neonatal intensive care units, and only one programme specifically targeted adolescents. The median duration was one day (range 5 min to 3.5 years). Development of competencies was the most common objective. We identified 12 different educational content areas. Content mainly focused on communication and relational competencies, including partnership, which involved shared decision-making, mutual agenda setting, and negotiation of a plan. Many kinds of educational strategies were found but experiential learning through simulation and roleplay was used most. Conclusion: A large variety of educational programmes in paediatric patient- and family-centred care exist. Educational content mainly focused on communication and relational competencies. Experiential learning including roleplay and simulation was the most used educational strategy. What is Known: • Delivery of patient- and family-centred care improves parental satisfaction of care but requires clinicians have a certain attitude towards involving the child and parents in a healthcare partnership as well as advanced triadic communication skills. Little is known about how this attitude, and more broadly, patient- and family-centred care, can be facilitated through education and training. What is New: • This scoping review found a wide array of programmes.. Workshops with simulation or roleplay was the most frequent educational strategy. The programmes, which typically targeted nurses and doctors, chiefly focused on basic and advanced communication and relational competencies, including partnership, which involved shared decision-making and negotiation of plans.
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Affiliation(s)
- Elisabeth Jeppesen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark.
- Department of Respiratory Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
| | - Anne Aarslev Schmidt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Camilla Kriegbaum Skjødt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
| | - Jakob Thestrup
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helena Hansson
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Boman C, Bernhardsson S, Lundqvist S, Melin K, Lauruschkus K. Physical activity on prescription for children with obesity: a focus group study exploring experiences in paediatric healthcare. FRONTIERS IN HEALTH SERVICES 2024; 4:1306461. [PMID: 38638607 PMCID: PMC11024476 DOI: 10.3389/frhs.2024.1306461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/21/2024] [Indexed: 04/20/2024]
Abstract
Background Insufficient physical activity is a growing public health concern and is closely linked to obesity in both adults and children. Swedish physical activity on prescription (PAP) is effective in increasing physical activity levels in adults, but knowledge about how PAP is used in paediatric healthcare is lacking. Therefore, this study aimed to explore experiences of working with PAP for children with obesity amongst paediatric staff and managers. Methods Seven focus group discussions with 26 participants from paediatric outpatient clinics in western Sweden were conducted. Data were analysed both inductively and deductively, framed by the Normalization Process Theory's four core constructs: coherence, cognitive participation, collective action, and reflexive monitoring. Results The PAP work for children with obesity was experienced to be about helping children to become physically active, and less about losing weight. Identified barriers for using PAP were the non-uniform nature of the work and a perceived lack of guidelines. Collaboration with physiotherapists and physical activity organisers outside the organisation was identified as an important facilitator. An important contextual factor for implementing PAP is the collaboration between paediatric clinics and physical activity organisers. In the transition between these stakeholders, maintaining a family-centred approach when working with PAP was experienced as challenging. Conclusions PAP is a well-known intervention that is inconsistently used for children with obesity. The intervention should include a family-centred approach for this patient group. It also needs to align better with existing collaborations with other healthcare units as well as with new forms of collaboration with physical activity organisers in the community.
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Affiliation(s)
- Charlotte Boman
- Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Susanne Bernhardsson
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Education Primary Health Care, Gothenburg, Sweden
| | - Stefan Lundqvist
- Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Education Primary Health Care, Gothenburg, Sweden
| | - Karin Melin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katarina Lauruschkus
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Habilitation, Committee on Psychiatry, Habilitation and Technical Aids, Malmö, Sweden
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Aita M, De Clifford‐Faugère G, Laporte G, Colson S, Feeley N. Nurses' perceptions about neonatal intensive care units providing family-centered care are associated with skin-to-skin contact implementation. Pediatr Investig 2024; 8:61-65. [PMID: 38516142 PMCID: PMC10951481 DOI: 10.1002/ped4.12402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/08/2023] [Indexed: 03/23/2024] Open
Affiliation(s)
- Marilyn Aita
- Faculty of NursingUniversité de MontréalMontrealCanada
- CHU Sainte‐Justine Research CentreMontrealCanada
- Quebec Network on Nursing Intervention ResearchMontrealCanada
| | | | - Geneviève Laporte
- Faculty of NursingUniversité de MontréalMontrealCanada
- CHU Sainte‐Justine Research CentreMontrealCanada
| | - Sébastien Colson
- Quebec Network on Nursing Intervention ResearchMontrealCanada
- Faculty of Medical and Paramedical SciencesCEReSSAix‐Marseille UniversitéMarseilleFrance
| | - Nancy Feeley
- Quebec Network on Nursing Intervention ResearchMontrealCanada
- Ingram School of NursingMcGill UniversityMontrealCanada
- Centre for Nursing Research and Lady Davis InstituteJewish General HospitalMontrealCanada
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Aldiss S, Gibson F, Vindrola-Padros C, Wray J, Kelly P. 'They could not see our eyes, they cannot see our faces, they do not know who we are and that is hard': a qualitative interview study with staff caring for children and families in a UK specialist children's hospital during the COVID-19 pandemic. BMJ Open 2023; 13:e070048. [PMID: 37316313 DOI: 10.1136/bmjopen-2022-070048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES Despite lower rates of illness, morbidity and mortality associated with SARS-CoV-2 infection in children during the COVID-19 pandemic, their health and well-being has been significantly impacted. Emerging evidence indicates that this includes experiences of hospital-based care for them and their families. As part of a series of multisite research studies to undertake a rapid appraisal of perceptions of hospital staff, working during the pandemic, our study focused on clinical and non-clinical staff perceptions of the impact of COVID-19 on aspects of care delivery, preparedness and staffing specific to a specialist children's hospital. DESIGN Qualitative study using a qualitative rapid appraisal design. Hospital staff participated in a telephone interview. We used a semistructured interview guide, and recorded and transcribed all interviews. Rapid Research Evaluation and Appraisal Lab Rapid Assessment Procedure sheets were used to share data; team-based analysis was facilitated using a framework approach. SETTING Specialist children's hospital in London, UK. PARTICIPANTS Thirty-six staff representing a range of roles within the hospital: 19 (53%) nurses, 7 (19%) medical staff and 10 (28%) other staff groups (including radiographers, managers, play staff, schoolteachers, domestic and portering staff and social workers). RESULTS Three overarching themes relating to staff perceptions of the impact on children and families were identified, each containing subthemes: (1) same hospital but different for everyone, (2) families paid the price and (3) the digital world. They illustrated that providing care and treatment for children and families changed profoundly during the pandemic, particularly during lockdown periods. Adaptations to deliver clinical care, play, schooling and other therapies online were rapidly put into action; however, benefits were not universal or always inclusive. CONCLUSIONS The disruption to a central principle of children's hospital care-the presence and involvement of families-was of critical concern to staff, suggesting a need for the specific impact of COVID-19 on children's services to be accounted for.
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Affiliation(s)
- Susie Aldiss
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Faith Gibson
- School of Health Sciences, University of Surrey, Guildford, UK
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Cecilia Vindrola-Padros
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Paula Kelly
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Kassam-Adams N, Butler L, Price J, Gawel M, Graham L, Myers S, Auerbach M. Trauma-informed and family-centered paediatric resuscitation: Defining domains and practices. Resusc Plus 2023; 14:100374. [PMID: 37007186 PMCID: PMC10064226 DOI: 10.1016/j.resplu.2023.100374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/28/2023] Open
Abstract
Aim For paediatric patients and families, resuscitation can be an extremely stressful experience with significant medical and psychological consequences. Psychological sequelae may be reduced when healthcare teams apply patient- and family-centered care and trauma-informed care, yet there are few specific instructions for effective family-centered or trauma-informed behaviours that are observable and teachable. We aimed to develop a framework and tools to address this gap. Methods We reviewed relevant policy statements, guidelines, and research to define core domains of family-centered and trauma-informed care, and identified observable evidence-based practices in each domain. We refined this list of practices via review of provider/team behaviours in simulated paediatric resuscitation scenarios, then developed and piloted an observational checklist. Results Six domains were identified: (1) Sharing information with patient and family; (2) Promoting family involvement in care and decisions; (3) Addressing family needs and distress; (4) Addressing child distress; (5) Promoting effective emotional support for child; (6) Practicing developmental and cultural competence. A 71-item observational checklist assessing these domains was feasible for use during video review of paediatric resuscitation. Conclusion This framework can guide future research and provide tools for training and implementation efforts to improve patient outcomes through patient- and family-centered and trauma-informed care.
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Affiliation(s)
- Nancy Kassam-Adams
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Lucas Butler
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Julia Price
- Nemours Children’s Health, 1600 Rockland Road, Wilmington, DE 19803, USA
- Sidney Kimmel Medical College at Thomas Jefferson University, 1025 Walnut St, Philadelphia, PA 19107, USA
| | - Marcie Gawel
- Yale New Haven Hospital, 20 York St, New Haven, CT 06510, USA
| | - Leila Graham
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Sage Myers
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Marc Auerbach
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
- Yale New Haven Children’s Hospital, 35 Park St, New Haven, CT 06511, USA
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Determeijer JJ, Leopold SJ, Spijker R, Agyemang C, van Vugt M. Family participation to enhance care and tackle health worker shortages in resource-limited hospitals: A systematic review. J Glob Health 2023; 13:04005. [PMID: 36655879 PMCID: PMC9853090 DOI: 10.7189/13.04005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background A growing global shortage of health workers is limiting access to health care, especially in resource-limited countries. Family participation in hospital care could enhance care while tackling health worker shortages. With the same resources, it might deliver additional and more personalised care. This review assessed the effect and safety of family participation interventions in the care of hospitalised adults in resource-limited settings and, ultimately, if it is a viable strategy to tackle health worker shortages. Methods For this systematic review, Medline, Embase, CINAHL and the Global Health Library were searched from inception till April 7, 2022. Clinical studies were included if they described a family participation intervention for hospitalised adults, were performed in a low- or middle-income country and reported on a patient-related outcome. Data were collected on patient, family, staff and health service-related outcomes. Risk of bias was assessed with the ROB2 and ROBINS-I tool. Results From 4444 studies, six were included for narrative synthesis, with a total of 1794 participants. Four studies were performed in Asia and two in Africa; all were published between 2017 and 2022. In-hospital family participation interventions aimed at medication administration and adherence, delirium prevention, and palliative cancer care were successful in significantly improving patient outcomes. Involving family in post-stroke rehabilitation interventions showed no significant effect on mortality and long-term disability. Few data were reported on participating family members' outcomes or hospital staffing issues. None of the included studies showed harm from family participation. Conclusions The limited data suggest that family participation can be effective and safe in specific contexts. However, more research is needed to determine the effect of family participation and justify further implementation. Family participation research for enhancing care while tackling health worker shortages should be a collaborative priority of researchers, health care professionals, funding agencies and policymakers. Registration PROSPERO registration No. CRD42020205878.
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Affiliation(s)
- Jim J Determeijer
- Department of Infectious disease, Amsterdam University Medical Centers, Amsterdam, the Netherlands,Department of Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Stije J Leopold
- Department of Infectious disease, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - René Spijker
- Department of Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands,Medical Library, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Charles Agyemang
- Department of Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Michèle van Vugt
- Department of Infectious disease, Amsterdam University Medical Centers, Amsterdam, the Netherlands,Department of Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands
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Strobel NA, Chamberlain C, Campbell SK, Shields L, Bainbridge RG, Adams C, Edmond KM, Marriott R, McCalman J. Family-centred interventions for Indigenous early childhood well-being by primary healthcare services. Cochrane Database Syst Rev 2022; 12:CD012463. [PMID: 36511823 PMCID: PMC9746601 DOI: 10.1002/14651858.cd012463.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Primary healthcare, particularly Indigenous-led services, are well placed to deliver services that reflect the needs of Indigenous children and their families. Important characteristics identified by families for primary health care include services that support families, accommodate sociocultural needs, recognise extended family child-rearing practices, and Indigenous ways of knowing and doing business. Indigenous family-centred care interventions have been developed and implemented within primary healthcare services to plan, implement, and support the care of children, immediate and extended family and the home environment. The delivery of family-centred interventions can be through environmental, communication, educational, counselling, and family support approaches. OBJECTIVES To evaluate the benefits and harms of family-centred interventions delivered by primary healthcare services in Canada, Australia, New Zealand, and the USA on a range of physical, psychosocial, and behavioural outcomes of Indigenous children (aged from conception to less than five years), parents, and families. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 22 September 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster RCTs, quasi-RCTs, controlled before-after studies, and interrupted time series of family-centred care interventions that included Indigenous children aged less than five years from Canada, Australia, New Zealand, and the USA. Interventions were included if they met the assessment criteria for family-centred interventions and were delivered in primary health care. Comparison interventions could include usual maternal and child health care or one form of family-centred intervention versus another. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were 1. overall health and well-being, 2. psychological health and emotional behaviour of children, 3. physical health and developmental health outcomes of children, 4. family health-enhancing lifestyle or behaviour outcomes, 5. psychological health of parent/carer. 6. adverse events or harms. Our secondary outcomes were 7. parenting knowledge and awareness, 8. family evaluation of care, 9. service access and utilisation, 10. family-centredness of consultation processes, and 11. economic costs and outcomes associated with the interventions. We used GRADE to assess the certainty of the evidence for our primary outcomes. MAIN RESULTS We included nine RCTs and two cluster-RCTs that investigated the effect of family-centred care interventions delivered by primary healthcare services for Indigenous early child well-being. There were 1270 mother-child dyads and 1924 children aged less than five years recruited. Seven studies were from the USA, two from New Zealand, one from Canada, and one delivered in both Australia and New Zealand. The focus of interventions varied and included three studies focused on early childhood caries; three on childhood obesity; two on child behavioural problems; and one each on negative parenting patterns, child acute respiratory illness, and sudden unexpected death in infancy. Family-centred education was the most common type of intervention delivered. Three studies compared family-centred care to usual care and seven studies provided some 'minimal' intervention to families such as education in the form of pamphlets or newsletters. One study provided a minimal intervention during the child's first 24 months and then the family-centred care intervention for one year. No studies had low or unclear risk of bias across all domains. All studies had a high risk of bias for the blinding of participants and personnel domain. Family-centred care may improve overall health and well-being of Indigenous children and their families, but the evidence was very uncertain. The pooled effect estimate from 11 studies suggests that family-centred care improved the overall health and well-being of Indigenous children and their families compared no family-centred care (standardised mean difference (SMD) 0.14, 95% confidence interval (CI) 0.03 to 0.24; 2386 participants). We are very uncertain whether family-centred care compared to no family-centred care improves the psychological health and emotional behaviour of children as measured by the Infant Toddler Social Emotional Assessment (ITSEA) (Competence domain) (mean difference (MD) 0.04, 95% CI -0.03 to 0.11; 2 studies, 384 participants). We assessed the evidence as being very uncertain about the effect of family-centred care on physical health and developmental health outcomes of children. Pooled data from eight trials on physical health and developmental outcomes found there was little to no difference between the intervention and the control groups (SMD 0.13, 95% CI -0.00 to 0.26; 1961 participants). The evidence is also very unclear whether family-centred care improved family-enhancing lifestyle and behaviours outcomes. Nine studies measured family health-enhancing lifestyle and behaviours and pooled analysis found there was little to no difference between groups (SMD 0.16, 95% CI -0.06 to 0.39; 1969 participants; very low-certainty evidence). There was very low-certainty evidence of little to no difference for the psychological health of parents and carers when they participated in family-centred care compared to any control group (SMD 0.10, 95% CI -0.03 to 0.22; 5 studies, 975 parents/carers). Two studies stated that there were no adverse events as a result of the intervention. No additional data were provided. No studies reported from the health service providers perspective or on outcomes for family's evaluation of care or family-centredness of consultation processes. AUTHORS' CONCLUSIONS There is some evidence to suggest that family-centred care delivered by primary healthcare services improves the overall health and well-being of Indigenous children, parents, and families. However, due to lack of data, there was not enough evidence to determine whether specific outcomes such as child health and development improved as a result of family-centred interventions. Seven of the 11 studies delivered family-centred education interventions. Seven studies were from the USA and centred on two particular trials, the 'Healthy Children, Strong Families' and 'Family Spirit' trials. As the evidence is very low certainty for all outcomes, further high-quality trials are needed to provide robust evidence for the use of family-centred care interventions for Indigenous children aged less than five years.
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Affiliation(s)
- Natalie A Strobel
- Kurongkurl Katitjin, Edith Cowan University, Mount Lawley, Australia
- Medical School, The University of Western Australia, Perth, Australia
| | - Catherine Chamberlain
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Sandra K Campbell
- College of Nursing & Midwifery, Charles Darwin University, Darwin, Australia
| | - Linda Shields
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Roxanne G Bainbridge
- School of Human Health and Social Sciences, Central Queensland University, Cairns, Australia
| | - Claire Adams
- Kurongkurl Katitjin, Edith Cowan University, Mount Lawley, Australia
| | - Karen M Edmond
- Department of Women and Children's Health, King's College London, London, UK
| | - Rhonda Marriott
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Murdoch, Australia
| | - Janya McCalman
- School of Human Health and Social Sciences, Central Queensland University, Cairns, Australia
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Mardhiyah A, Panduragan SL, Mediani HS. Reducing Psychological Impacts on Children with Chronic Disease via Family Empowerment: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10102034. [PMID: 36292480 PMCID: PMC9602354 DOI: 10.3390/healthcare10102034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/27/2022] [Accepted: 10/12/2022] [Indexed: 11/04/2022] Open
Abstract
Chronic diseases cause physical and psychological impacts on sufferers. In dealing with illness, the family is not involved in the treatment of chronic diseases. Children also do not receive support from their families in dealing with their illness. Family empowerment is an important thing to implement in treating children with chronic diseases. The purpose of this study was to explore family empowerment interventions as potential methods to reduce the impact of chronic disease. This study used the scoping review method. A literature review was conducted via CINAHL, PubMed, and ProQuest databases. The keywords used in English were "family empowerment OR family center empowerment" AND "child OR children" AND "chronic disease". The criteria for articles in this study were full text, free access, randomized control trial or quasi-experiment research design, English language, population and samples of chronic disease, and the publication period of the last 10 years (2013-2022). We found nine articles that used a family empowerment intervention in an effort to reduce the impact of chronic disease on children. Most of the study designs were randomized control trial and quasi-experiment. Some of the benefits of family empowerment interventions were quality of life, family care, and self-ability. The interventions helped the families to be empowered and actively participate in caring for children with chronic diseases. There were nine articles that discussed family empowerment interventions that have an impact in dealing with the impact of chronic disease on children, namely improving quality of life, family care, and self-ability.
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Affiliation(s)
- Ai Mardhiyah
- Faculty of Health Science, Lincoln University College, Petaling Jaya 47301, Malaysia
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
- Correspondence: ; Tel.: +60-3-7806-3478
| | | | - Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
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Kainiemi E, Flacking R, Lehtonen L, Pasanen M, Axelin A. Psychometric Properties of an Instrument to Measure the Quality of Family-Centered Care in NICUs. J Obstet Gynecol Neonatal Nurs 2022; 51:461-472. [PMID: 35598704 DOI: 10.1016/j.jogn.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To examine the psychometric properties of the Digi Family-Centered Care-Parent Version (DigiFCC-P), which was developed to measure parents' perceptions of family-centered care (FCC) in NICUs. DESIGN Cross-sectional psychometric study. SETTING Twenty-three NICUs in 15 countries in Europe, Canada, and Australia. PARTICIPANTS Mothers (n = 565) and fathers (n = 406) of preterm infants hospitalized in NICUs. METHODS Participants reported their perceptions of the quality of FCC during their infants' hospitalizations by answering one DigiFCC-P question delivered to their mobile phones every evening. Nine questions rotated in random order. Participants responded on a 7-point Likert scale. We evaluated the instrument's internal consistency, construct and concurrent validity, and sensitivity. RESULTS The internal consistency of the DigiFCC-P was satisfactory; the Cronbach's alpha coefficient was .74 (95% confidence interval [.71, .77]), and all the corrected item-total correlations were greater than .30. We identified that the items formed two factors, support from staff and the parent's active participation, and observed no strong item cross-loadings on the two factors. We discovered some items with weak interitem correlations, and the two factors explained 35.2% of the variance. Scores on the DigiFCC-P and Family-Centered Care Questionnaire were significantly correlated (r = .59, p < .001) and supported the convergent validity of the instrument. In addition, changes were discovered in the participants' ratings over time, which indicated that the instrument was sensitive to detect changes in their evaluations. CONCLUSION The psychometric testing of the DigiFCC-P provided initial support for the convergent validity and reliability of the instrument. The instrument was also sensitive in detecting changes in the evaluations of FCC over time. However, there is a need for further development of the content validity of the instrument.
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Zimmermann K, Marfurt-Russenberger K, Cignacco E, Bergstraesser E. Bereaved parents' perspectives on their child's end-of-life care: connecting a self-report questionnaire and interview data from the nationwide Paediatric End-of-LIfe CAre Needs in Switzerland (PELICAN) study. Palliat Care 2022; 21:66. [PMID: 35509046 PMCID: PMC9066872 DOI: 10.1186/s12904-022-00957-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 04/27/2022] [Indexed: 12/02/2022] Open
Abstract
Background Paediatric Palliative Care (PPC) focuses on ensuring the best possible quality of life for the child and his/her family by extending beyond the physical domain into psychosocial and spiritual wellbeing. A deep understanding of what is important to parents is crucial in guiding the further evaluation and improvement of PPC and end-of-life (EOL) care services. Much can be learned from specific positive and negative experiences of bereaved parents with the EOL care of their child. This report builds upon a questionnaire survey as part of the national Paediatric End-of-LIfe CAre Needs in Switzerland (PELICAN) study. Methods One part of the PELICAN study was set up to assess and explore the parental perspectives on their child’s EOL care. Interview data were used to explain the extremely positive and negative results of a quantitative survey in an explanatory sequential mixed-methods approach. Data integration occurred at different points: during sampling of the interview participants, when designing the interview guide and during analysis. A narrative approach was applied to combine the qualitative results reported here with the already published quantitative survey results. Results Eighteen mothers (60%) and twelve fathers (40%) participated in 20 family interviews. All parents reported having both positive and negative experiences during their child’s illness and EOL, which was characterised by many ups and downs. The families transitioned through phases with a prospect of a cure for some children as well as setbacks and changing health status of the child which influenced prognosis, leading to the challenge of making extremely difficult decisions. Severely negative experiences still haunted and bothered the parents at the time when the interview took place. Conclusions A deep understanding of the perspectives and needs of parents going through the devastating event of losing a child is important and a prerequisite to providing compassionate care. This complex care needs to recognise and respond to the suffering not only of the child but of the parents and the whole family. Communication and shared decision-making remain pivotal, as do still improvable elements of care that should build on trustful relationships between families and healthcare professionals.
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Affiliation(s)
- Karin Zimmermann
- Department Public Health (DPH), Nursing Science, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. .,Paediatric Palliative Care and Children's Research Center CRC, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
| | | | - Eva Cignacco
- Health Department, Bern University of Applied Sciences, Bern, Switzerland
| | - Eva Bergstraesser
- Paediatric Palliative Care and Children's Research Center CRC, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
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Jerofke-Owen TA, McAndrew NS, Gralton KS, Totka JP, Weiss ME, Fial AV, Sawin KJ. Engagement of Families in the Care of Hospitalized Pediatric Patients: A Scoping Review. JOURNAL OF FAMILY NURSING 2022; 28:151-171. [PMID: 34605283 DOI: 10.1177/10748407211048894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This scoping review was conducted to examine the range, nature, and extent of the published family engagement literature specific to the pediatric acute care setting to highlight future research and practice development opportunities. Included studies (N = 247) revealed global relevance. Engagement strategies ranged from more passive such as allowing/encouraging families to be present at the bedside to more active strategies aimed at promoting mutual and reciprocal nurse-patient interactions. Family engagement is distinguished by a mutually beneficial partnership of families with health care team members and care organizations. Future research in the area of family engagement in pediatric nursing should focus on determining the core engaging health professional behaviors and engaged parent outcomes; extending the knowledge base related to mutually beneficial partnerships between families and health care teams; developing effectiveness studies to determine the optimal engaging actions by teams to achieve parent engagement; and measuring the influence of engagement on parent and infant/child outcomes.
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Affiliation(s)
| | - Natalie S McAndrew
- University of Wisconsin-Milwaukee, USA
- Froedtert Hospital & the Medical College of Wisconsin, Milwaukee, USA
| | | | - Joan P Totka
- Marquette University, Milwaukee, WI, USA
- Children's Wisconsin, Milwaukee, USA
| | | | | | - Kathleen J Sawin
- University of Wisconsin-Milwaukee, USA
- Children's Wisconsin, Milwaukee, USA
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12
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Poojari DP, Umakanth S, Maiya GA, Rao BK, Brien M, Narayan A. Perceptions of family-centred care among caregivers of children with cerebral palsy in South India: An exploratory study. Child Care Health Dev 2022; 48:286-297. [PMID: 34791682 DOI: 10.1111/cch.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 09/05/2021] [Accepted: 10/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parental views and expectations about family-centred care (FCC) need to be understood for its successful implementation. Knowledge of caregiver's perceptions and needs, within their social and cultural context, forms the basis for effective health care partnerships with families. The purpose of this study was to explore perceptions about FCC among caregivers of children with cerebral palsy (CP) in South India. METHOD Fourteen caregivers of children with CP (aged 4-12 years) living in rural areas of the coastal region of Karnataka, India, participated in this qualitative study. Face-to-face semi-structured interviews were recorded and transcribed for analysis using the framework and hybrid approaches. Thematic mapping of the categories and themes was done to explore relationships about perceptions of FCC. RESULTS Caregiver's life emerged inductively as a new theme highlighting caregiver's own physical and mental health, family roles and well-being, integrating the onus of care with household responsibilities, limited participation in personal activities and social isolation. The qualitative findings revealed the ubiquity of respectful and trusting relationships with health professionals while expressing paucity of coordinated comprehensive care, sporadic partnerships and opportunities for shared decision-making; desire for receiving specific information related to child's progress and prognosis; and general information on community resources and the need of empowerment and support groups. CONCLUSION Our study has practical implications for the implementation of FCC within the South Indian context, by recognizing unique caregiver needs and expectations in sync with cultural perspectives towards childhood disability such as societal stigma, values and traditional beliefs; attitudes towards medical professionals; and life stressors and gender responsibilities.
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Affiliation(s)
- Deepalaxmi Paresh Poojari
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shashikiran Umakanth
- Department of Medicine, Dr TMA Pai Hospital, Udupi, Karnataka, India.,Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - G Arun Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bhamini Krishna Rao
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Marie Brien
- Enabling Inclusion Program, Amar Seva Sangam, Ayikudi, Tamil Nadu, India.,Rehabilitative Services, Prince County Hospital, Summerside, Prince Edward Island, Canada
| | - Amitesh Narayan
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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13
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Lowe D, Ryan R, Schonfeld L, Merner B, Walsh L, Graham-Wisener L, Hill S. Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. Cochrane Database Syst Rev 2021; 9:CD013373. [PMID: 34523117 PMCID: PMC8440158 DOI: 10.1002/14651858.cd013373.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Health services have traditionally been developed to focus on specific diseases or medical specialties. Involving consumers as partners in planning, delivering and evaluating health services may lead to services that are person-centred and so better able to meet the needs of and provide care for individuals. Globally, governments recommend consumer involvement in healthcare decision-making at the systems level, as a strategy for promoting person-centred health services. However, the effects of this 'working in partnership' approach to healthcare decision-making are unclear. Working in partnership is defined here as collaborative relationships between at least one consumer and health provider, meeting jointly and regularly in formal group formats, to equally contribute to and collaborate on health service-related decision-making in real time. In this review, the terms 'consumer' and 'health provider' refer to partnership participants, and 'health service user' and 'health service provider' refer to trial participants. This review of effects of partnership interventions was undertaken concurrently with a Cochrane Qualitative Evidence Synthesis (QES) entitled Consumers and health providers working in partnership for the promotion of person-centred health services: a co-produced qualitative evidence synthesis. OBJECTIVES To assess the effects of consumers and health providers working in partnership, as an intervention to promote person-centred health services. SEARCH METHODS We searched the CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL databases from 2000 to April 2019; PROQUEST Dissertations and Theses Global from 2016 to April 2019; and grey literature and online trial registries from 2000 until September 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-RCTs, and cluster-RCTs of 'working in partnership' interventions meeting these three criteria: both consumer and provider participants meet; they meet jointly and regularly in formal group formats; and they make actual decisions that relate to the person-centredness of health service(s). DATA COLLECTION AND ANALYSIS Two review authors independently screened most titles and abstracts. One review author screened a subset of titles and abstracts (i.e. those identified through clinical trials registries searches, those classified by the Cochrane RCT Classifier as unlikely to be an RCT, and those identified through other sources). Two review authors independently screened all full texts of potentially eligible articles for inclusion. In case of disagreement, they consulted a third review author to reach consensus. One review author extracted data and assessed risk of bias for all included studies and a second review author independently cross-checked all data and assessments. Any discrepancies were resolved by discussion, or by consulting a third review author to reach consensus. Meta-analysis was not possible due to the small number of included trials and their heterogeneity; we synthesised results descriptively by comparison and outcome. We reported the following outcomes in GRADE 'Summary of findings' tables: health service alterations; the degree to which changed service reflects health service user priorities; health service users' ratings of health service performance; health service users' health service utilisation patterns; resources associated with the decision-making process; resources associated with implementing decisions; and adverse events. MAIN RESULTS We included five trials (one RCT and four cluster-RCTs), with 16,257 health service users and more than 469 health service providers as trial participants. For two trials, the aims of the partnerships were to directly improve the person-centredness of health services (via health service planning, and discharge co-ordination). In the remaining trials, the aims were indirect (training first-year medical doctors on patient safety) or broader in focus (which could include person-centredness of health services that targeted the public/community, households or health service delivery to improve maternal and neonatal mortality). Three trials were conducted in high income-countries, one was in a middle-income country and one was in a low-income country. Two studies evaluated working in partnership interventions, compared to usual practice without partnership (Comparison 1); and three studies evaluated working in partnership as part of a multi-component intervention, compared to the same intervention without partnership (Comparison 2). No studies evaluated one form of working in partnership compared to another (Comparison 3). The effects of consumers and health providers working in partnership compared to usual practice without partnership are uncertain: only one of the two studies that assessed this comparison measured health service alteration outcomes, and data were not usable, as only intervention group data were reported. Additionally, none of the included studies evaluating this comparison measured the other primary or secondary outcomes we sought for the 'Summary of findings' table. We are also unsure about the effects of consumers and health providers working in partnership as part of a multi-component intervention compared to the same intervention without partnership. Very low-certainty evidence indicated there may be little or no difference on health service alterations or health service user health service performance ratings (two studies); or on health service user health service utilisation patterns and adverse events (one study each). No studies evaluating this comparison reported the degree to which health service alterations reflect health service user priorities, or resource use. Overall, our confidence in the findings about the effects of working in partnership interventions was very low due to indirectness, imprecision and publication bias, and serious concerns about risk of selection bias; performance bias, detection bias and reporting bias in most studies. AUTHORS' CONCLUSIONS The effects of consumers and providers working in partnership as an intervention, or as part of a multi-component intervention, are uncertain, due to a lack of high-quality evidence and/or due to a lack of studies. Further well-designed RCTs with a clear focus on assessing outcomes directly related to partnerships for patient-centred health services are needed in this area, which may also benefit from mixed-methods and qualitative research to build the evidence base.
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Affiliation(s)
- Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | | | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Grundt H, Tandberg BS, Flacking R, Drageset J, Moen A. Associations Between Single-Family Room Care and Breastfeeding Rates in Preterm Infants. J Hum Lact 2021; 37:593-602. [PMID: 33035125 PMCID: PMC8414820 DOI: 10.1177/0890334420962709] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hospitalization in neonatal intensive care units with a single-family room design enables continuous maternal presence, but less is known regarding the association with milk production and breastfeeding. RESEARCH AIM To compare maternal milk production, breastfeeding self-efficacy, the extent to which infants received mother's milk, and rate of direct breastfeeding in a single-family room to an open bay neonatal intensive care unit. METHODS A longitudinal, prospective observational study comparing 77 infants born at 28- 32° weeks gestational age and their 66 mothers (n = 35 infants of n = 30 mothers in single family room and n = 42 infants of n = 36 mothers in open bay). Comparisons were made on milk volume produced, the extent to which infants were fed mother's milk, and rate of direct breastfeeding from birth to 4 months' corrected infant age. Breastfeeding self-efficacy was compared across mothers who directly breastfed at discharge (n = 45). RESULTS First expression (6 hr vs. 30 hr, p < .001) and first attempt at breastfeeding (48 hr vs. 109 hr, p < .001) occurred significantly earlier, infants were fed a greater amount of mother's milk (p < .04), and significantly more infants having single-family room care were exclusively directly breastfed from discharge until 4 months' corrected age; OR 6.8 (95% CI [2.4, 19.1]). Volumes of milk produced and breastfeeding self-efficacy did not differ significantly between participants in either units. CONCLUSION To increase the extent to which infants are fed mother's own milk and are exclusively directly breastfed, the design of neonatal intensive care units should facilitate continuous maternal presence and privacy for the mother-infant dyad.
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Affiliation(s)
- Hege Grundt
- 60498 Department of Neonatology, Haukeland University Hospital
| | - Bente Silnes Tandberg
- 155273 Department of Pediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust.,Lovisenberg Diaconal University College.,Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen
| | - Renée Flacking
- 3317 School of Education, Health and Social Studies, Dalarna University, Sweden
| | - Jorunn Drageset
- 1658 Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen.,Institute of Nursing, Faculty of Health and Social sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Atle Moen
- 155273 Department of Pediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust.,Department of Neonatology, Oslo University Hospital
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15
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Ridgway L, Hackworth N, Nicholson JM, McKenna L. Working with families: A systematic scoping review of family-centred care in universal, community-based maternal, child, and family health services. J Child Health Care 2021; 25:268-289. [PMID: 32602735 DOI: 10.1177/1367493520930172] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children's long- and short-term health and developmental outcomes can be improved when families are engaged and supported, and inform care planning. Family-centred care (FCC) underpins policy directions for universal, community-based, child and family health services in the early years, although its implementation in this context is poorly understood. This systematic scoping review of the current literature aimed to improve understanding of FCC implementation in maternal, child, and family health universal services. Key databases and grey literature were searched using descriptors of maternal, child, and family health population and context, and FCC concept. Reference checking identified further literature for analysis. Thirteen included papers reported on nine studies from Australia, New Zealand, and the United Kingdom. Limited participant representation of fathers and diverse community members was evident. Deductive thematic analysis identified four areas of FCC demonstrated in this literature: respectful relationships, effective communication to foster shared understanding, flexible and contextualized care, and support for autonomy and agency. The literature demonstrated the interplay between organizational, professional, and recipient factors and their impact on the implementation of FCC. For successful FCC implementation, all these elements should be considered.
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Affiliation(s)
- Lael Ridgway
- 110497School of Nursing and Midwifery La Trobe University, Australia.,Judith Lumley Centre, 2080La Trobe University
| | - Naomi Hackworth
- Judith Lumley Centre, 2080La Trobe University.,435100Parenting Research Centre, Australia.,Murdoch Childrens Research Institute, Australia
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16
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Raghupathy MK, Rao BK, Nayak SR, Spittle AJ, Parsekar SS. Effect of family-centered care interventions on motor and neurobehavior development of very preterm infants: a protocol for systematic review. Syst Rev 2021; 10:59. [PMID: 33602324 PMCID: PMC7890856 DOI: 10.1186/s13643-021-01612-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, very preterm birth is a health concern leading to various developmental difficulties such as poor motor and/or cognitive function. For infants born very preterm, family-centered care (FCC) might promote developmental skills over the time in an appropriate enriched environment. The purpose of this study is to systematically review and assess the evidence of FCC interventions on the motor and neurobehavioral development in very preterm infants. Additionally, this review aims to determine the factors that might affect infant development. METHODS Systematic review will be carried out by including (a) quasi-randomized controlled trials and randomized controlled trials (b) of very preterm born infants (born < 32 weeks of gestation), and their primary caregivers will be included in the review (c) who received FCC-based interventions such as collaborative interaction between a healthcare professional and a parent, home program, home visits, and parent education, and (d) measure motor and neurobehavioral function. Electronic databases such as Scopus, PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and PsycINFO will be searched using database-specific terms. Additionally, searches will be carried out in ProQuest, and references of included studies will be searched. Two review authors, independently, will conduct the screening, data extraction, and critical appraisal of included studies. If possible, a meta-analysis will be undertaken to assess the effect of the FCC on the motor and neurobehavior of premature infants. CONCLUSION The review will provide insights regarding the effect of the FCC on preterm infants. This systematic review will guide the clinicians on the feasibility of practicing FCC that might support and promote the integration of parents into various rehabilitation settings. SYSTEMATIC REVIEW REGISTRATION Protocol has been registered in PROSPERO on August 26, 2020.
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Affiliation(s)
- Manasa Kolibylu Raghupathy
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Bhamini Krishna Rao
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, India.
| | - Shubha R Nayak
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Alicia J Spittle
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Shradha S Parsekar
- Public Health Evidence South Asia, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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17
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Frakking T, Michaels S, Orbell-Smith J, Le Ray L. Framework for patient, family-centred care within an Australian Community Hospital: development and description. BMJ Open Qual 2021; 9:bmjoq-2019-000823. [PMID: 32354755 PMCID: PMC7213886 DOI: 10.1136/bmjoq-2019-000823] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/31/2020] [Accepted: 04/18/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To describe the development of a patient and family-centred care (PFCC) conceptual framework within a small community Australian Hospital. METHODS A scoping review of scientific and grey literature and community hospital stakeholder discussions were used to identify and design a conceptual framework for PFCC across five core pillars of leadership, engagement, service delivery, learning and environment. RESULTS 107 publications were identified and 76 were included for data extraction. A draft framework was constructed and modified following consultation with hospital stakeholders across a small Australian Community Hospital. The 'Caring Together' framework outlines three core layers: (1) the focus of our care is the experiences of our consumers and staff; (2) concepts of leadership, environment, service delivery, engagement and learning; and (3) the overarching fundamental values of being heard, respected, valued and supported by staff and consumers at all levels in an organisation. CONCLUSIONS The conceptual Caring Together framework structures key PFCC concepts across organisational priority areas within an Australian healthcare setting and can be used to guide implementation of PFCC at other small hospital facilities. Changes to national and state healthcare funding may help facilitate improved hospital facility implementation of PFCC, and ultimately improve consumer healthcare satisfaction and clinical outcomes.
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Affiliation(s)
- Thuy Frakking
- Research Development Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia .,School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Suzanne Michaels
- Engagement & Integration, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Jane Orbell-Smith
- Education & Training, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Lance Le Ray
- Executive Management, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
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18
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Terp K, Weis J, Lundqvist P. Parents' Views of Family-Centered Care at a Pediatric Intensive Care Unit-A Qualitative Study. Front Pediatr 2021; 9:725040. [PMID: 34513770 PMCID: PMC8424181 DOI: 10.3389/fped.2021.725040] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/04/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose: To describe parents' views of family-centered care at a pediatric intensive care unit. Design and Methods: A qualitative descriptive study with a deductive and inductive approach was conducted based on the principles of family-centered care. Inclusion criteria were parents of children cared for at a pediatric intensive care unit for at least 48 h. Parents of children who died during the hospital stay were excluded. The sample consisted of spontaneous responses from 70 parents to five open questions in the EMpowerment of PArents in THe Intensive Care questionnaire, which was completed at discharge. The spontaneous responses were analyzed using thematic analysis. Results: The analysis of the parents' statement illuminated that partnership, the essence of family-centered care, appeared incomplete. Partnership was particularly evident regarding parents' experiences of being treated with empathy and respect. It also seemed prominent in situations where the professional team provided support to the child, parents, and family. Based on the parents' statements there was potential for development of the family-centered care approach in aspects such as decision-making concerning care and treatment, as well as improving person-centered communication on order to capture parents' experiences and needs in the highly technological pediatric intensive care unit environment. Conclusions: Although in general parents were satisfied with the care, areas for improvement were identified such as participation in decision-making about care and treatment as well as person-centered communication. The results can contribute to future quality improvement interventions focusing family centered care at pediatric intensive care units.
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Affiliation(s)
- Karina Terp
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Janne Weis
- Department of Neonatology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Pia Lundqvist
- Department of Health Sciences, Lund University, Lund, Sweden
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19
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North N, Leonard A, Bonaconsa C, Duma T, Coetzee M. Distinctive nursing practices in working with mothers to care for hospitalised children at a district hospital in KwaZulu-Natal, South Africa: a descriptive observational study. BMC Nurs 2020; 19:28. [PMID: 32327935 PMCID: PMC7169043 DOI: 10.1186/s12912-020-00421-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background The presence of family members and their active involvement in caring for hospitalised children is an established practice in many African paediatric settings, with family members often regarded as a resource. This aspect of African paediatric nursing practice lacks formal expression or a clear conceptual basis, and difficulties arise when applying concepts of family involvement originating from the culturally distinct practice environments of higher resourced settings including Europe and America. The aim of this study was to articulate a nurse-led practice innovation intended to facilitate family involvement in the care of hospitalised children, observed in a paediatric inpatient ward in a district hospital in rural KwaZulu-Natal, South Africa. Methods A qualitative case study design was used. Data collection included visual research methods (graphic facilitation, sociograms and photo-elicitation) as well as a focus group, interviews and practice observation. Activities associated with 20 nurses and 22 mother-child dyads were observed. Data were subjected to content analysis, with Standards for Reporting Qualitative Research (SRQR) applied. Results Findings relate to six aspects of practice, categorised thematically as: preserving the mother-child pair; enabling continuous presence; psychological support and empathy; sharing knowledge; mothers as a resource; and belief and trust. Conclusion The nursing practices and organisational policies observed in this setting relating to the facilitation of continuous maternal presence represent a distinctive nursing practice innovation. This deliberate practice contrasts with models of care provision which originate in higher resourced settings including Europe and America, such as Family Centred Care, and contrasts with informal practices in local African settings which tolerate the presence of mothers in other settings, as well as local institutional policies which limit mothers’ presence to varying extents.
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Affiliation(s)
- Natasha North
- Child Nurse Practice Development Initiative, Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Klipfontein Road, Rondebosch, Cape Town, South Africa
| | - Angela Leonard
- Child Nurse Practice Development Initiative, Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Klipfontein Road, Rondebosch, Cape Town, South Africa
| | - Candice Bonaconsa
- Child Nurse Practice Development Initiative, Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Klipfontein Road, Rondebosch, Cape Town, South Africa
| | - Thobeka Duma
- Child Nurse Practice Development Initiative, Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Klipfontein Road, Rondebosch, Cape Town, South Africa
| | - Minette Coetzee
- Child Nurse Practice Development Initiative, Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Klipfontein Road, Rondebosch, Cape Town, South Africa
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Naef R, Kläusler-Troxler M, Ernst J, Huber S, Dinten-Schmid B, Karen T, Petry H. Translating family systems care into neonatology practice: A mixed method study of practitioners’ attitudes, practice skills and implementation experience. Int J Nurs Stud 2020; 102:103448. [DOI: 10.1016/j.ijnurstu.2019.103448] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
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Lundgren J, Norell-Clarke A, Hellström I, Angelhoff C. Adolescents' Experiences of Staying Overnight at Family-Centered Pediatric Wards. SAGE Open Nurs 2020; 6:2377960819900690. [PMID: 33415262 PMCID: PMC7774335 DOI: 10.1177/2377960819900690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/19/2019] [Accepted: 12/23/2019] [Indexed: 11/15/2022] Open
Abstract
Background Sleep is essential for health and recovery. Hospital stays may affect adolescents' sleep quality negatively as routines in the ward are not adapted for adolescents' developmental status or sleep habits. The aims with this study were to (a) explore and describe how adolescents experience sleep in the family-centered pediatric ward, (b) explore and describe how adolescents experience the presence or absence of a parent during the hospital stay, and (c) identify circumstances that the adolescents describe as influential of their sleep in the pediatric wards. Methods This is a qualitative interview study employing thematic analysis with an inductive and exploratory approach. Sixteen adolescents aged between 13 and 17 years participated in the study. Results Three themes were found: the importance of good sleep, safety as a prerequisite for sleep in hospital, and circumstances influencing adolescents' sleep in hospital. Conclusion The adolescents described their sleep at the pediatric ward positively, but mentioned disturbing factors associated with pain, nightly check-ups, noises, and inactivity. Parental presence was perceived as very positive both during the night and the day.
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Affiliation(s)
- Johan Lundgren
- Department of Social and Welfare Studies, Division of Nursing Science, Linköping University, Norrköping, Sweden
| | - Annika Norell-Clarke
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden.,Research Platform for Collaboration for Health, Kristianstad University, Kristianstad, Sweden
| | - Ingrid Hellström
- Department of Social and Welfare Studies, Division of Nursing Science, Linköping University, Norrköping, Sweden.,Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Charlotte Angelhoff
- Crown Princess Victoria Children's Hospital, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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22
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Prasopkittikun T, Srichantaranit A, Chunyasing S. Thai nurses' perceptions and practices of family-centered care: The implementation gap. Int J Nurs Sci 2020; 7:74-80. [PMID: 32099863 PMCID: PMC7031120 DOI: 10.1016/j.ijnss.2019.09.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/28/2019] [Accepted: 09/26/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives This study was conducted to examine the differences between perceptions and practices of family-centered care among Thai pediatric nurses. Methods This mixed-methods study consisted of two phases. In the first phase, a descriptive comparative design using the Family-Centered Care Questionnaire - Revised (FCCQ-R) was administered to 142 pediatric nurses from a university hospital in Bangkok, Thailand. In the second phase, qualitative interviews were conducted with 16 pediatric nurses to gather complementary information regarding the major findings from the first phase. Results The results revealed that family strengths and individuality were rated the highest as the most important elements and the most frequent practices. Parent/professional collaboration was perceived as the least important element, while the design of the heath care delivery system was rated as the least frequent practice. The qualitative data revealed that the major reasons for suboptimal implementation included a common perception that family-centered care is a Western concept, nurses' weak attitudes towards their roles, and a shortage of nurses. Conclusions Nurses agreed that the identified elements of family-centered care were necessary but that they did not incorporate the concepts into their daily nursing practice to maintain their endorsement of the family-centered care model. Further study is needed to explore how family-centered care is understood and operationalized by Thai nurses and how hospital administration and environments can be modified to support this care model.
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Affiliation(s)
| | | | - Sirisopa Chunyasing
- Department of Nursing Siriraj Hospital, Mahidol University, Bangkok, Thailand
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23
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Tandberg BS, Flacking R, Markestad T, Grundt H, Moen A. Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit. PLoS One 2019; 14:e0224488. [PMID: 31689307 PMCID: PMC6830777 DOI: 10.1371/journal.pone.0224488] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/15/2019] [Indexed: 01/30/2023] Open
Abstract
Background Studies of parents’ psychological well-being in single-family rooms in neonatal intensive care units have shown conflicting results. Aims To compare emotional distress in the form of depression, anxiety, stress and attachment scores among parents of very preterm infants cared for in a single-family rooms unit vs an open bay unit. Study design Prospective survey design. Subject Parents (132) of 77 infants born at 28 0/7–32 0/7 weeks of gestation in the two units. Outcome measures Duration of parental presence was recorded. Scores for depression (The Edinburgh Postnatal Depression Scale), anxiety (The State–Trait–Anxiety Inventory, Short Form Y), stress (The Parent Stressor Scale: neonatal intensive care unit questionnaire and The Parenting Stress Index—short form) and attachment (Maternal Postnatal Attachment Scale) measured 14 days after delivery, at discharge, expected term date and four months post-term. Results Parents were present 21 hours/day in the single-family room unit vs 7 hours/day in the Open bay unit. Ninety-three percent of the fathers in the single-family rooms unit were present more than 12 hours per day during the first week. Mothers in the single-family rooms had a significantly lower depression score -1.9 (95% CI: -3.6, -0.1) points from birth to four months corrected age compared to mothers in the Open bay unit, and 14% vs 52% scored above a cut-off point considered being at high risk for depression (p<0.005). Both mothers and fathers in the single-family rooms reported significantly lower stress levels during hospitalization. There were no differences between the groups for anxiety, stress or attachment scores after discharge. Conclusion The lower depression scores by the mothers and lower parental stress scores during hospitalization for both parents supports that single-family rooms care contribute to parents’ psychological wellbeing.
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Affiliation(s)
- Bente Silnes Tandberg
- Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
- Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- * E-mail:
| | - Renée Flacking
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Trond Markestad
- Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Hege Grundt
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Atle Moen
- Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Department of Neonatology, Oslo University Hospital, Oslo, Norway
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24
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Abrams HR, Leeds HS, Russell HV, Hellsten MB. Factors Influencing Family Burden in Pediatric Hematology/Oncology Encounters. J Patient Cent Res Rev 2019; 6:243-251. [PMID: 31768403 DOI: 10.17294/2330-0698.1710] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose Caring for a child with cancer or hematologic disease places unique stress on a family unit. Families' subjective experience of this care-related burden mediates the relationship between cost and health-related outcomes. While financial costs are well described for families of pediatric hematology/oncology patients, it is unclear how cost and other factors each contribute to families' overall experience of care-related burden. This study identifies and groups the challenges that families report and describes their association with overall reported burden. Methods This mixed-methods analysis of a cross-sectional single-center study was conducted via structured, self-administered questionnaire provided to inpatient and outpatient caregivers of pediatric hematology/oncology patients. Respondents rated their perception of burden associated with that day's medical encounter on a 5-point Likert scale. The questionnaire included an open-ended prompt for caregivers about areas they deemed most burdensome. Primary themes were extracted and categorized. Results A total of 278 outpatient and 42 inpatient caregivers participated. Six thematic categories emerged: logistics, life disruption, care delivery system, parking, financial burden, and emotional burden. Outpatient caregivers reported more burden than inpatient caregivers for the first three categories, while inpatient caregivers reported more burden for the last three. Salient subthemes associated with higher and lower overall burden were identified in each theme category. Conclusions These data establish theme categories for future study of caregiver-perceived burden in pediatric hematologic/oncologic encounters, demonstrate that certain components of cost contribute disproportionately to caregivers' overall sense of care-related burden, and identify areas within each of the 6 burden categories that can be best targeted to alleviate caregiver burden.
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Affiliation(s)
| | - Hayden S Leeds
- Texas Children's Cancer and Hematology Centers, Department of Pediatrics, Baylor College of Medicine, Houston TX.,Oregon Health & Science University, Portland, OR
| | - Heidi V Russell
- Texas Children's Cancer and Hematology Centers, Department of Pediatrics, Baylor College of Medicine, Houston TX.,Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX
| | - Melody B Hellsten
- Texas Children's Cancer and Hematology Centers, Department of Pediatrics, Baylor College of Medicine, Houston TX
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25
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Feldmann J, Puhan MA, Mütsch M. Characteristics of stakeholder involvement in systematic and rapid reviews: a methodological review in the area of health services research. BMJ Open 2019; 9:e024587. [PMID: 31420378 PMCID: PMC6701675 DOI: 10.1136/bmjopen-2018-024587] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Engaging stakeholders in reviews is considered to generate more relevant evidence and to facilitate dissemination and use. As little is known about stakeholder involvement, we assessed the characteristics of their engagement in systematic and rapid reviews and the methodological quality of included studies. Stakeholders were people with a particular interest in the research topic. DESIGN Methodological review. SEARCH STRATEGY Four databases (Medline, Embase, Cochrane database of systematic reviews, databases of the University of York, Center for Reviews and Dissemination (CRD)) were searched based on an a priori protocol. Four types of reviews (Cochrane and non-Cochrane systematic reviews, rapid and CRD rapid reviews) were retrieved between January 2011 and October 2015, pooled by potential review type and duplicates excluded. Articles were randomly ordered and screened for inclusion and exclusion criteria until 30 reviews per group were reached. Their methodological quality was assessed using AMSTAR and stakeholder characteristics were collected. RESULTS In total, 57 822 deduplicated citations were detected with potential non-Cochrane systematic reviews being the biggest group (56 986 records). We found stakeholder involvement in 13% (4/30) of Cochrane, 20% (6/30) of non-Cochrane, 43% (13/30) of rapid and 93% (28/30) of CRD reviews. Overall, 33% (17/51) of the responding contact authors mentioned positive effects of stakeholder involvement. A conflict of interest statement remained unmentioned in 40% (12/30) of non-Cochrane and in 27% (8/30) of rapid reviews, but not in Cochrane or CRD reviews. At most, half of non-Cochrane and rapid reviews mentioned an a priori study protocol in contrast to all Cochrane reviews. CONCLUSION Stakeholder engagement was not general practice, except for CRD reviews, although it was more common in rapid reviews. Reporting factors, such as including an a priori study protocol and a conflict of interest statement should be considered in conjunction with involving stakeholders.
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Affiliation(s)
- Jonas Feldmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo Alan Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Margot Mütsch
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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26
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Foster M, Whitehead L, Arabiat D. Development and validation of the needs of children questionnaire: An instrument to measure children's self-reported needs in hospital. J Adv Nurs 2019; 75:2246-2258. [PMID: 31197863 PMCID: PMC6852052 DOI: 10.1111/jan.14099] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 03/17/2019] [Accepted: 04/02/2019] [Indexed: 12/26/2022]
Abstract
Aim To develop and psychometrically test the needs of children questionnaire (NCQ), a new instrument to measure school‐aged children's self‐reported psychosocial physical and emotional needs in paediatric wards. Design This is an instrument development study based on recommendations for developing a reliable and valid questionnaire. Method The NCQ was developed over three phases between February 2013–April 2017 and included item generation; content adequacy assessment; questionnaire administration; factor analysis; internal consistency assessment and construct validity. Psychometric properties were assessed after 193 school‐aged children completed the needs of children's questionnaire in four paediatric areas in Australia and New Zealand. Results The development and validation of the NCQ over two countries resulted in a 16‐item, four‐category tool to measure the self‐reported importance and fulfilment of school‐aged children's needs in hospital. Cronbach's alpha for the combined samples was 0.93. Conclusion The NCQ bridges a gap to measure the level of importance and fulfilment of school‐aged children's self‐reported needs in hospital. Future testing and validation is needed in other paediatric areas and countries. Impact The 16‐item NCQ is a valid measure to evaluate if the quality of care delivered and received in hospital is in line with what children self‐report as important and required and to date indicates good usability and utility. Child self‐reports are essential to inform healthcare delivery, policy, research and theory development from a child and family‐centred care lens that honours the United Nations Convention on the Rights of the Child and the best interests of the child.
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Affiliation(s)
- Mandie Foster
- School of Nursing and Midwifery, Edith Cowan Univeristy, Joondalup, Perth, Western Australia, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan Univeristy, Joondalup, Perth, Western Australia, Australia.,Postgraduate Centre for Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Diana Arabiat
- School of Nursing and Midwifery, Edith Cowan Univeristy, Joondalup, Perth, Western Australia, Australia.,The University of Jordan, School of Nursing, Amman, Jordan
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27
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Lowe D, Merner B, Graham-Wisener L, Walsh L, Hill S. The effects of consumers and health providers working in partnership as an intervention for the promotion of person-centred health services. Hippokratia 2019. [DOI: 10.1002/14651858.cd013373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Dianne Lowe
- La Trobe University; Centre for Health Communication and Participation, School of Psychology and Public Health; Bundoora VIC Australia 3086
| | - Bronwen Merner
- La Trobe University; Centre for Health Communication and Participation, School of Psychology and Public Health; Bundoora VIC Australia 3086
| | | | - Louisa Walsh
- La Trobe University; Centre for Health Communication and Participation, School of Psychology and Public Health; Bundoora VIC Australia 3086
| | - Sophie Hill
- La Trobe University; Centre for Health Communication and Participation, School of Psychology and Public Health; Bundoora VIC Australia 3086
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28
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Humanization interventions in general pediatric wards: a systematic review. Eur J Pediatr 2019; 178:607-622. [PMID: 30949888 DOI: 10.1007/s00431-019-03370-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 02/23/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023]
Abstract
Humanization of care (HOC) interventions have rarely been evaluated and compared. We systematically reviewed the outcomes of published interventions aimed to improve the HOC for hospitalized children. PubMed and Scopus were used as data sources. Studies published between January 1, 2000, and February 28, 2018, were considered eligible if they reported analysis of results vs. either a control group or baseline, or if they measured patient/family/staff satisfaction. Neonatal age, emergency departments, and subspecialty settings were excluded. Data were extracted using a standardized data extraction form including study design, sample size, intervention, outcome/objective, and evaluation of results or pre- post-intervention satisfaction. Twenty-eight of the 12,012 retrieved articles met the inclusion criteria. Most studies were of moderate to low quality. Only six studies were of high quality. Areas of interest dealt with environment (n = 4), provider-patient relationship (n = 6), pet therapy (n = 5), technology (n = 5), family-centered rounds (n = 2), psychological support (n = 3), and staff training (n = 3). The overall trend of the results indicated that interventions were mostly effective and likely to have beneficial effects on several aspects of pediatric hospitalization.Conclusions: Pending further studies of better research quality, the findings of this review may have policy and practice implications for planning HOC interventions by pediatric healthcare professionals. What is Known: • In pediatrics, humanization of care (HOC) provides assistance focused not only on the child as a patient, but on the whole family. • HOC programs have been developed, but information on the overall outcome of local projects aiming to improve in a practical way the hospital taking charge of pediatric patients is still lacking. What is New: • Local HOC interventions are mostly effective and have beneficial effects on several aspects of hospitalization in general pediatrics wards. • The findings of this review may have practice implications for planning HOC interventions by pediatric healthcare professionals.
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29
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Boland L, Graham ID, Légaré F, Lewis K, Jull J, Shephard A, Lawson ML, Davis A, Yameogo A, Stacey D. Barriers and facilitators of pediatric shared decision-making: a systematic review. Implement Sci 2019; 14:7. [PMID: 30658670 PMCID: PMC6339273 DOI: 10.1186/s13012-018-0851-5] [Citation(s) in RCA: 146] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/27/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM) is rarely implemented in pediatric practice. Pediatric health decision-making differs from that of adult practice. Yet, little is known about the factors that influence the implementation of pediatric shared decision-making (SDM). We synthesized pediatric SDM barriers and facilitators from the perspectives of healthcare providers (HCP), parents, children, and observers (i.e., persons who evaluated the SDM process, but were not directly involved). METHODS We conducted a systematic review guided by the Ottawa Model of Research Use (OMRU). We searched MEDLINE, EMBASE, Cochrane Library, CINAHL, PubMed, and PsycINFO (inception to March 2017) and included studies that reported clinical pediatric SDM barriers and/or facilitators from the perspective of HCPs, parents, children, and/or observers. We considered all or no comparison groups and included all study designs reporting original data. Content analysis was used to synthesize barriers and facilitators and categorized them according to the OMRU levels (i.e., decision, innovation, adopters, relational, and environment) and participant types (i.e., HCP, parents, children, and observers). We used the Mixed Methods Appraisal Tool to appraise study quality. RESULTS Of 20,008 identified citations, 79 were included. At each OMRU level, the most frequent barriers were features of the options (decision), poor quality information (innovation), parent/child emotional state (adopter), power relations (relational), and insufficient time (environment). The most frequent facilitators were low stake decisions (decision), good quality information (innovation), agreement with SDM (adopter), trust and respect (relational), and SDM tools/resources (environment). Across participant types, the most frequent barriers were insufficient time (HCPs), features of the options (parents), power imbalances (children), and HCP skill for SDM (observers). The most frequent facilitators were good quality information (HCP) and agreement with SDM (parents and children). There was no consistent facilitator category for observers. Overall, study quality was moderate with quantitative studies having the highest ratings and mixed-method studies having the lowest ratings. CONCLUSIONS Numerous diverse and interrelated factors influence SDM use in pediatric clinical practice. Our findings can be used to identify potential pediatric SDM barriers and facilitators, guide context-specific barrier and facilitator assessments, and inform interventions for implementing SDM in pediatric practice. TRIAL REGISTRATION PROSPERO CRD42015020527.
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Affiliation(s)
- Laura Boland
- Faculty of Health Sciences, University of Ottawa, 540 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Ian D Graham
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 307D-600 Peter Morand Cresent, Ottawa, ON, K1G 5Z3, Canada
| | - France Légaré
- CHU de Québec Research Centre-Université Laval site Hôpital St-Francois d'Assise, 10 Rue Espinay, Quebec City, Quebec, G1L 3L5, Canada
| | - Krystina Lewis
- Faculty of Health Sciences, University of Ottawa, 540 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, 31 George Street Kingston, Ottawa, ON, K7L 3N6, Canada
| | - Allyson Shephard
- Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Margaret L Lawson
- Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Alexandra Davis
- Learning Services, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada
| | - Audrey Yameogo
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Dawn Stacey
- Faculty of Health Sciences, University of Ottawa, 540 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada.
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
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Aarthun A, Øymar KA, Akerjordet K. Parental involvement in decision-making about their child's health care at the hospital. Nurs Open 2019; 6:50-58. [PMID: 30534394 PMCID: PMC6279730 DOI: 10.1002/nop2.180] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 06/07/2018] [Indexed: 12/30/2022] Open
Abstract
AIM To explore parents' experiences on parental involvement in decision-making about their child's health care at the hospital and to identify how health professionals can improve parental involvement. DESIGN An explorative descriptive qualitative study within a constructivist research paradigm. METHODS Individual semistructured interviews were conducted with a purposive sample of 12 parents. Qualitative content analysis was performed. RESULTS This study gives unique insight into how parental involvement in children's healthcare decisions influence parents' ability to cope with the parental role at the hospital. The results showed that parents' competence and perceived influence and control over their child's health care appeared to affect how they mastered their role of involvement in decision-making. Individually tailored and respectful facilitation of parental involvement in these decisions by health professionals seemed to improve parents' influence, control and ability to cope with the parental role. Nurses should thus strengthen parents' sense of coherence enhancing the quality of health care.
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Affiliation(s)
- Antje Aarthun
- Department of PaediatricsStavanger University HospitalStavangerNorway
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Knut A. Øymar
- Department of PaediatricsStavanger University HospitalStavangerNorway
- University of BergenBergenNorway
| | - Kristin Akerjordet
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
- School of Psychology, Faculty of Social SciencesUniversity of Wollongong NSWAustralia
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31
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Gill FJ, Leslie GD, Marshall AP. Barriers and facilitators to implementing a process to enable parent escalation of care for the deteriorating child in hospital. Health Expect 2018; 21:1095-1103. [PMID: 29962031 PMCID: PMC6250884 DOI: 10.1111/hex.12806] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To identify barriers and facilitators to implementing a parent escalation of care process: Calling for Help (C4H). DESIGN Audits, semi-structured interviews and focus groups guided by the Theoretical Domains Framework. SETTING Australian paediatric hospital where a parent escalation of care process was introduced in the previous 6 months. PARTICIPANTS Four children, 13 parents, 91 nurses and doctors including Medical Emergency Team (MET) members. MAIN OUTCOME MEASURES Parent awareness and involvement in escalating care and factors impacting implementation of C4H. RESULTS Two audits identified low level of parent awareness (16/88, 19% and 5/85, 6%). Parent involvement in escalation of care was documented in 11/62 (18%) events. The main facilitators included uniformly positive views that C4H was in the child's best interest, acknowledgement that parents had skills to recognize deterioration and would take action. C4H was considered to add to patient safety and being reviewed by the MET was a patient benefit. Key barriers were the low level of awareness, doubt about parent capabilities, concern about parents' information overload, anticipated overuse of resources, staff unease about possible repercussions and anticipated difficulty for parents to question staff with potential negative effects on parent-staff relationships. Overall C4H presents a challenge to traditional hospital hierarchy and culture. CONCLUSIONS Although there was a low level of awareness about C4H in practice, there was in-principle support for the concept. Initial strategies had primarily targeted policy change without taking into account the need for practice and organizational behaviour changes. Using a theoretical approach to identify key factors will enable a targeted approach to implementation.
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Affiliation(s)
- Fenella J. Gill
- School of Nursing, Midwifery and ParamedicineFaculty of Health SciencesCurtin UniversityPerthWAAustralia
- Perth Children's HospitalChild and Adolescent Health ServicesPerthWAAustralia
| | - Gavin D. Leslie
- School of Nursing, Midwifery and ParamedicineFaculty of Health SciencesCurtin UniversityPerthWAAustralia
| | - Andrea P. Marshall
- School of Nursing and Midwifery Clinical ChairGold Coast HealthSouthportQldAustralia
- Centre for Health Practice InnovationMenzies Health Institute QueenslandSouthportQldAustralia
- School of Nursing and MidwiferyGriffith UniversitySouthportQldAustralia
- Gold Coast Hospital and Health ServiceGold Coast University HospitalSouthportQldAustralia
- Nursing and Midwifery Education and Research UnitSouthportQldAustralia
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32
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Marthinsen GN, Helseth S, Fegran L. Sleep and its relationship to health in parents of preterm infants: a scoping review. BMC Pediatr 2018; 18:352. [PMID: 30419873 PMCID: PMC6231258 DOI: 10.1186/s12887-018-1320-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/24/2018] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Sleep is essential for human health and functioning. Parents of preterm infants are susceptible to sleep disturbances because of stress related to the preterm birth. Poor sleep has the potential to affect parental health and well-being. The aim of this study was to identify and map evidence on sleep and its relationship to health in parents of preterm infants. No review has summarized the evidence on this topic. METHODS A scoping review was conducted. Seven health and medical electronic research databases were searched for relevant quantitative and qualitative primary studies, including grey literature. The search was performed March 2-7, 2017. RESULTS Ten American studies and one Australian study were included in the review. Most research was quantitative and focused on maternal sleep and mental health within the first two weeks after the childbirth. Both objective and subjective sleep measures were used to study sleep at the hospital; actigraphs were not used after discharge. Maternal sleep was poor early postpartum, and this was associated with negative health outcomes. Two cohort studies compared sleep in mothers of preterm and term infants, but the results were conflicting. In one qualitative study, fathers described their inability to catch up on sleep after homecoming with a preterm baby. CONCLUSIONS Quantitative studies reporting on maternal sleep early postpartum was most frequently occurring in the results. Qualitative research on the topic was identified as a knowledge gap. More cultural and geographical breadth, including research on fathers' sleep, is recommended in future research.
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Affiliation(s)
- Gunhild Nordbø Marthinsen
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
| | - Sølvi Helseth
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, NO-0130 Oslo, Norway
| | - Liv Fegran
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
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McDowell R, McKendry A, Smyth G, Cardwell P. Reflection on the assessment and care of a child with osteogenesis imperfecta. Nurs Child Young People 2018; 30:26-29. [PMID: 30375204 DOI: 10.7748/ncyp.2018.e1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2018] [Indexed: 11/09/2022]
Abstract
Osteogenesis imperfecta (OI) is a rare genetic condition that causes bones to become brittle and fracture. This article draws on the reflective experiences of two second-year children's nursing students on placement. It includes a case study that explores the assessment and care of a child with OI. Due to the lack of available evidence and understanding of nursing care for children with OI, the article also includes a personal reflection on clinical practice. There has been extensive development in evidence-based practice in nursing, which includes reflective practice. Reflection is an important component of nursing training and plays a part in ensuring that nurses keep their knowledge and skills up to date and gain valuable transferable skills. This article presents a reflection on nursing a child with OI along with more specific information on OI.
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Affiliation(s)
| | | | - Gabrielle Smyth
- Education, School of Nursing and Midwifery, Queen's University Belfast, Northern Ireland
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Parents' and Health Professionals' Views of Collaboration in the Management of Childhood Long-term Conditions. J Pediatr Nurs 2018; 43:36-44. [PMID: 30473155 DOI: 10.1016/j.pedn.2018.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 08/16/2018] [Accepted: 08/18/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE To explore how parents and health professionals view the concept and practice of collaboration in the management of childhood long-term conditions. DESIGNS AND METHODS A qualitative research approach was adopted; sixteen parents and six health professionals participated in either individual or group interviews. Data analysis was underpinned by the Framework approach and involved an iterative process of reading the transcribed data, identifying and refining key themes until a coherent picture emerged. RESULTS Two main concepts were identified: expectations of collaboration and mechanisms for collaboration. Health professionals' expectations of collaborative practice were influenced by their knowledge, experience and relative objectivity. They used relationship building with families as a key strategy for collaboration. Parents' expectations of collaboration varied and appeared to be influenced by their experience of living with their child's condition. Parents' needs were often unmet, particularly in relation to support with coordinating or accessing care on behalf of their child. Parents' strategies included resilience, assertiveness, determination and battling for what they needed. CONCLUSION Parents and professionals valued collaboration as a concept but differed in their expectations of collaborative practice and adopted different mechanisms to foster meaningful collaboration. A better understanding of the unique needs and experiences of parents of a child with a long-term condition is key to developing positive collaborative practice. PRACTICE IMPLICATIONS Collaborative practice could be enhanced by health professionals' being more responsive to the full range of parent support needs, and being more pro-active about helping them work with the complexities of care systems.
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Mumford V, Baysari MT, Kalinin D, Raban MZ, McCullagh C, Karnon J, Westbrook JI. Measuring the financial and productivity burden of paediatric hospitalisation on the wider family network. J Paediatr Child Health 2018; 54:987-996. [PMID: 29671913 PMCID: PMC6635734 DOI: 10.1111/jpc.13923] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/26/2017] [Accepted: 02/25/2018] [Indexed: 11/30/2022]
Abstract
AIM To estimate the non-medical out-of-pocket costs for families with a child in hospital. METHODS This study was a survey of 225 parents of paediatric inpatients on nine wards of an Australian public paediatric teaching hospital on two separate days. Our primary outcomes were the costs associated with: (i) time taken off work to care for the child in hospital; (ii) time off work or contributed by family and friends to care for other dependents; and (iii) travel, meals, accommodation and incidental expenses during the child's stay. Demographic data included postcode (to assess distance, socio-economic status and remoteness), child's age, ward and whether this was their child's first admission. RESULTS Mean patient age was 6.5 years (standard deviation 5.2). On an average per patient day basis, parents took 1.12 days off work and spent 0.61 (standard deviation 0.53) nights away from home, with 83.8% of nights away at the child's bedside. Parents spent Australian dollars (AUD)89 per day on travel and AUD36 on meals and accommodation. Total costs (including productivity costs) were AUD589 per patient day. Higher costs per patient day were correlated with living in a more remote area (0.48) and a greater travel distance to the hospital (0.41). A higher number of days off work was correlated (0.69) with number of school days missed. CONCLUSION These results demonstrate the considerable time and financial resources expended by families caring for a child in hospital and are important inputs in evaluating health-care interventions that affect risk of hospitalisation and length of stay in paediatric care.
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Affiliation(s)
- Virginia Mumford
- Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
| | - Melissa T Baysari
- Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia,St Vincent's Clinical SchoolUniversity of New South WalesSydneyNew South WalesAustralia
| | - Djala Kalinin
- Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
| | - Magdalena Z Raban
- Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
| | - Cheryl McCullagh
- The Sydney Children's Hospital NetworkSydneyNew South WalesAustralia,Sydney Medical School, University of SydneySydneyNew South WalesAustralia
| | - Jonathon Karnon
- School of Public Health, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Johanna I Westbrook
- Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
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Abstract
Teachers in hospitals are a unique phenomenon. Their students are sick, hospitalized children with a range of physical, emotional, and cognitive needs. Teachers are expected to be dynamic, flexible, creative, open-minded, and efficient to function in the most appropriate manner. However, a recent study showed that these teachers tend to procrastinate on some of the most common tasks that teachers perform on a daily basis in the regular school system. The present study was an initial investigation into the reasons for procrastination in teachers who work in two hospitals in Israel. Thirty-two teachers were interviewed. The findings indicated that the primary reason for procrastination among teachers in the hospital was professional role ambiguity, with emotional factors and situational determinants which were identified. Future research should further explore reasons for procrastination in the workplace, in general, and its association with professional role ambiguity specifically.
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Affiliation(s)
- Meirav Hen
- a Tel-Hai Academic College , Kiryat Shmona , Israel
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Steketee G, Ross AM, Wachman MK. Health Outcomes and Costs of Social Work Services: A Systematic Review. Am J Public Health 2017; 107:S256-S266. [PMID: 29236534 DOI: 10.2105/ajph.2017.304004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Efforts to reduce expensive health service utilization, contain costs, improve health outcomes, and address the social determinants of health require research that demonstrates the economic value of health services in population health across a variety of settings. Social workers are an integral part of the US health care system, yet the specific contributions of social work to health and cost-containment outcomes are unknown. The social work profession's person-in-environment framework and unique skillset, particularly around addressing social determinants of health, hold promise for improving health and cost outcomes. OBJECTIVES To systematically review international studies of the effect of social work-involved health services on health and economic outcomes. SEARCH METHODS We searched 4 databases (PubMed, PsycINFO, CINAHL, Social Science Citation Index) by using "social work" AND "cost" and "health" for trials published from 1990 to 2017. SELECTION CRITERIA Abstract review was followed by full-text review of all studies meeting inclusion criteria (social work services, physical health, and cost outcomes). DATA COLLECTION AND ANALYSIS Of the 831 abstracts found, 51 (6.1%) met criteria. Full text review yielded 16 studies involving more than 16 000 participants, including pregnant and pediatric patients, vulnerable low-income adults, and geriatric patients. We examined study quality, health and utilization outcomes, and cost outcomes. MAIN RESULTS Average study quality was fair. Studies of 7 social work-led services scored higher on quality ratings than 9 studies of social workers as team members. Most studies showed positive effects on health and service utilization; cost-savings were consistent across nearly all studies. CONCLUSIONS Despite positive overall effects on outcomes, variability in study methods, health problems, and cost analyses render generalizations difficult. Controlled hypothesis-driven trials are needed to examine the health and cost effects of specific services delivered by social workers independently and through interprofessional team-based care. Public Health Implications. The economic and health benefits reported in these studies suggest that the broad health perspective taken by the social work profession for patient, personal, and environmental needs may be particularly valuable for achieving goals of cost containment, prevention, and population health. Novel approaches that move beyond cost savings to articulate the specific value-added of social work are much needed. As health service delivery focuses increasingly on interprofessional training, practice, and integrated care, more research testing the impact of social work prevention and intervention efforts on the health and well-being of vulnerable populations while also measuring societal costs and benefits is essential.
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Affiliation(s)
- Gail Steketee
- Gail Steketee is with the Boston University School of Social Work, Boston, MA. Abigail M. Ross is with the Fordham Graduate School of Social Service, New York, NY. Madeline K. Wachman is with the Center for Innovation in Social Work and Health, Boston University School of Social Work
| | - Abigail M Ross
- Gail Steketee is with the Boston University School of Social Work, Boston, MA. Abigail M. Ross is with the Fordham Graduate School of Social Service, New York, NY. Madeline K. Wachman is with the Center for Innovation in Social Work and Health, Boston University School of Social Work
| | - Madeline K Wachman
- Gail Steketee is with the Boston University School of Social Work, Boston, MA. Abigail M. Ross is with the Fordham Graduate School of Social Service, New York, NY. Madeline K. Wachman is with the Center for Innovation in Social Work and Health, Boston University School of Social Work
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The Need for Support and Not Distress Evoking: A Meta-Synthesis of Experiences of Iranian Parents with Premature Infants. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2017. [DOI: 10.5812/ijpbs.5916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fletcher R, Dowse E, St George J, Payling T. Mental health screening of fathers attending early parenting services in Australia. J Child Health Care 2017; 21:498-508. [PMID: 29110526 DOI: 10.1177/1367493517732166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Paternal perinatal depression and anxiety is a common, though under-recognized mental health condition experienced by men during their transition to fatherhood. An opportunity to screen for paternal mental health issues occurs when parents present for assistance with the care of their baby at early parenting services (EPSs). There are 10 EPSs located across Australia that provide specialist, multidisciplinary interventions to support parents experiencing complex parenting difficulties. Using structured telephone interviews, this qualitative study explored the views of 18 professional staff from nine EPSs regarding screening, referral processes and acceptability of screening fathers for mental health issues. A thematic analysis revealed that most EPSs screened fathers for depression. Participants agreed screening was important and that routine approaches to screening would help normalize the process for both men and services. Despite this, no uniform, comprehensive approach to identifying the mental health needs of fathers was found. EPSs provide a unique opportunity to address the mental health needs of fathers. Results from this study point to the need for a national approach to the development of father-specific screening guidelines for EPSs to improve family well-being, in parallel to those informing the Australian National Perinatal Mental Health Initiative for mothers.
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Affiliation(s)
- Richard Fletcher
- 1 Family Action Centre, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Eileen Dowse
- 2 School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Jennifer St George
- 3 Family Action Centre, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Tara Payling
- 4 Family Action Centre, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
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Smyth W, Abernethy G, Jessup M, Douglas T, Shields L. Family-centred care in cystic fibrosis: a pilot study in North Queensland, Australia. Nurs Open 2017; 4:168-173. [PMID: 28694981 PMCID: PMC5500987 DOI: 10.1002/nop2.84] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 03/24/2017] [Indexed: 11/10/2022] Open
Abstract
AIMS The aims were to: (i) examine perceptions of family-centred care of parents of children with cystic fibrosis and healthcare professionals who care for them; (ii) test design and tools in a regional population. DESIGN Quantitative pilot study of existing questionnaire. METHODS The methods involved were comparative, cross-sectional survey of parents of children with cystic fibrosis and health staff in North Queensland, using "Perceptions of Family Centered Care - Parent" and "Perceptions of Family Centered Care - Staff" questionnaires; and descriptive study of tools. RESULTS Eighteen staff, 14 parents (78%, 61%); using Mann-Whitney U, showed no significant differences in scores in categories: 'support' 'respect', 'collaboration'. Comments about suitability of questionnaires varied, but were largely positive.
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Affiliation(s)
- Wendy Smyth
- Nursing Research Unit, Townsville Hospital and Health Service Townsville Queensland Australia.,College of Healthcare Sciences James Cook University Townsville Queensland Australia
| | - Gail Abernethy
- Tropical Health Research Unit Townsville Hospital and Health Service Townsville Australia
| | - Melanie Jessup
- Australian Catholic University/Metro North Hospital and Health Service Brisbane Queensland Australia.,Queensland Children's Medical Research Institute The University of Queensland Brisbane Queensland Australia
| | - Tonia Douglas
- Respiratory Unit, Lady Cilento Children's Hospital South Brisbane Queensland Australia.,Curtin University Bentley Western Australia Australia
| | - Linda Shields
- Faculty of Science, Charles Sturt University Bathurst New South Wales Australia.,School of Medicine The University of Queensland Brisbane Queensland Australia
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Davies S, Salmon P, Young B. When trust is threatened: Qualitative study of parents' perspectives on problematic clinical relationships in child cancer care. Psychooncology 2017; 26:1301-1306. [PMID: 28494129 PMCID: PMC5600008 DOI: 10.1002/pon.4454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We explored parents' accounts of the parent-clinician relationship in childhood cancer to understand how parents who perceive threats to the relationship can be supported. METHODS Multicentre longitudinal qualitative study, with 67 UK parents of children (aged 1-12 years) receiving treatment for acute lymphoblastic leukaemia. Analyses drew on the wider sample but focussed on 50 semistructured interviews with 20 parents and were informed by constant comparison. RESULTS All 20 parents described problems with clinical care such as inadequate information or mistakes by staff but varied in how much the problems threatened their sense of relationship with clinicians. Some parents saw the problems as having no relevance to the parent-clinician relationship. Others saw the problems as threats to the clinical relationship but worked to "contain" the threat in ways that preserved a trusting relationship with at least one senior clinician. Parents' containment work protected the security they needed from the parent-clinician relationship, but containment was a tenuous process for some. A few parents were unable to contain the problems at all; lacking trust in clinicians, these parents suffered considerably. CONCLUSIONS Given the complexity of childhood cancer care, problems with clinical care are inevitable. By engaging in containment work, parents met their needs to feel secure in the face of these problems, but the extent to which parents should have to do this work is debatable. Parents could benefit from support to seek help when problems arise which threaten their trust in clinicians. Attachment theory can guide clinicians in giving this support.
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Affiliation(s)
- Sarah Davies
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Peter Salmon
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Bridget Young
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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Alabdulaziz H, Moss C, Copnell B. Paediatric nurses’ perceptions and practices of family-centred care in Saudi hospitals: A mixed methods study. Int J Nurs Stud 2017; 69:66-77. [DOI: 10.1016/j.ijnurstu.2017.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 10/20/2022]
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McCalman J, Heyeres M, Campbell S, Bainbridge R, Chamberlain C, Strobel N, Ruben A. Family-centred interventions by primary healthcare services for Indigenous early childhood wellbeing in Australia, Canada, New Zealand and the United States: a systematic scoping review. BMC Pregnancy Childbirth 2017; 17:71. [PMID: 28222689 PMCID: PMC5320754 DOI: 10.1186/s12884-017-1247-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary healthcare services in Australia, Canada, New Zealand and the United States have embraced the concept of family-centred care as a promising approach to supporting and caring for the health of young Indigenous children and their families. This scoping review assesses the quality of the evidence base and identifies the published literature on family- centred interventions for Indigenous early childhood wellbeing. METHODS Fourteen electronic databases, grey literature sources and the reference lists of Indigenous maternal and child health reviews were searched to identify relevant publications from 2000 to 2015. Studies were included if the intervention was: 1) focussed on Indigenous children aged from conception to 5 years from the abovementioned countries; 2) led by a primary healthcare service; 3) described or evaluated; and 4) scored greater than 50% against a validated scale for family-centredness. The study characteristics were extracted and quality rated. Reported aims, strategies, enablers and outcomes of family-centredcare were identified using grounded theory methods. RESULTS Eighteen studies (reported in 25 publications) were included. Three were randomised controlled studies; most were qualitative and exploratory in design. More than half of the publications were published from 2012 to 2015. The overarching aim of interventions was to promote healthy families. Six key strategies were to: support family behaviours and self- care, increase maternal knowledge, strengthen links with the clinic, build the Indigenous workforce, promote cultural/ community connectedness and advocate for social determinants of health. Four enablers were: competent and compassionate program deliverers, flexibility of access, continuity and integration of healthcare, and culturally supportive care. Health outcomes were reported for Indigenous children (nutritional status; emotional/behavioural; and prevention of injury and illness); parents/caregivers (depression and substance abuse; and parenting knowledge, confidence and skills); health services (satisfaction; access, utilization and cost) and community/cultural revitalisation. DISCUSSION AND CONCLUSION The evidence for family-centred interventions is in the early stages of development, but suggests promise for generating diverse healthcare outcomes for Indigenous children and their parents/caregivers, as well as satisfaction with and utilisation of healthcare, and community/cultural revitalisation. Further research pertaining to the role of fathers in family-centred care, and the effects and costs of interventions is needed.
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Affiliation(s)
| | | | | | | | | | | | - Alan Ruben
- Apunipima Cape York Health Council, Bungalow, Australia
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McCalman J, Campbell SK, Chamberlain C, Strobel NA, Bainbridge RG, Wenitong M, Ruben A, Edmond KM, Marriott R, Tsey K, Keith K, Shields L. Family-centred interventions for Indigenous early childhood well-being by primary healthcare services. Hippokratia 2016. [DOI: 10.1002/14651858.cd012463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Janya McCalman
- Central Queensland University; School of Human Health and Social Sciences; Cnr Abbott and Shields St Cairns Queensland Australia 4870
| | - Sandra K Campbell
- James Cook University; Centre for Chronic Disease Prevention; McGregor Rd Cairns Queensland Australia 4878
| | - Catherine Chamberlain
- Baker IDI Heart & Diabetes Institute; Aboriginal Health Domain; L4/99 Commercial Rd Prahan Melbourne Vic Australia 3004
| | - Natalie A Strobel
- The University of Western Australia; School of Paediatrics and Child Health; 35 Stirling Highway Crawley Western Australia Australia 6009
| | - Roxanne G Bainbridge
- Central Queensland University; School of Human Health and Social Sciences; Cnr Abbott and Shields St Cairns Queensland Australia 4870
| | - Mark Wenitong
- Apunipima Cape York Health Service; 186 McCoombe Street Cairns Queensland Australia 4870
| | - Alan Ruben
- Apunipima Cape York Health Service; 186 McCoombe Street Cairns Queensland Australia 4870
| | - Karen M Edmond
- The University of Western Australia; School of Paediatrics and Child Health; 35 Stirling Highway Crawley Western Australia Australia 6009
| | - Rhonda Marriott
- Murdoch University; School of Psychology and Exercise Science; 90 South Street Murdoch Western Australia Australia 6150
| | - Komla Tsey
- James Cook University; The Cairns Institute; McGregor Road Cairns Queensland Australia 4870
| | - Katrina Keith
- James Cook University; The Cairns Institute; McGregor Road Cairns Queensland Australia 4870
| | - Linda Shields
- Charles Sturt University; School of Nursing, Midwifery and Indigenous Health; Bathurst NSW Australia
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Dennis C, Baxter P, Ploeg J, Blatz S. Models of partnership within family-centred care in the acute paediatric setting: a discussion paper. J Adv Nurs 2016; 73:361-374. [PMID: 27706840 DOI: 10.1111/jan.13178] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 12/16/2022]
Abstract
AIMS A discussion of partnership in the context of family-centred care in the acute paediatric setting, through a critical analysis of partnership models. BACKGROUND Paediatric healthcare practitioners understand the importance of family-centred care, but struggle with how to translate the core tenets into action and are confused by several rival terms. Partnering relationships are included in definitions of family-centred care, yet less is known about strategies to fully engage or support parents in these partnerships. A rigorous examination of concepts embedded in family-centred care such as partnership may provide a better understanding of how to implement the broader concept and support exemplary care in today's clinical practice environment. DESIGN Discussion paper. DATA SOURCES Electronic search (January 2000 - December 2014) performed on CINAHL, Medline, EMBASE, Sociological Abstracts and PsychINFO using keywords partnership, family-centred care and conceptual framework. Eligible references were drawn from the databases, reference lists and expert sources. Eight models met inclusion criteria and had currency and relevance to the acute paediatric setting. IMPLICATIONS FOR NURSING Nurses should continue exploring partnership in various paediatric contexts given the wide-ranging definitions, lack of operational indicators and need for stronger relational statements in current models. An examination of key strategies, barriers and facilitators of partnership is recommended. CONCLUSION One partnership model had both high overall maturity and best fit with family-centred care principles. All models originate from Western and developed countries, indicating that future partnership models should be more geographically, culturally and economically diverse.
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Affiliation(s)
- Christine Dennis
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Pamela Baxter
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Susan Blatz
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
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Feeg VD, Paraszczuk AM, Çavuşoğlu H, Shields L, Pars H, Al Mamun A. How is Family Centered Care Perceived by Healthcare Providers from Different Countries? An International Comparison Study. J Pediatr Nurs 2016; 31:267-76. [PMID: 26712214 DOI: 10.1016/j.pedn.2015.11.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/05/2015] [Accepted: 11/07/2015] [Indexed: 11/16/2022]
Abstract
UNLABELLED Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness." DESIGN AND METHODS The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476). RESULTS The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey. CONCLUSIONS Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education. PRACTICE IMPLICATIONS The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation.
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Affiliation(s)
| | | | | | - Linda Shields
- Charles Sturt University, Bathurst, NSW, Australia; University of Queensland, Herston, Australia
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Curtis K, Foster K, Mitchell R, Van C. Models of Care Delivery for Families of Critically Ill Children: An Integrative Review of International Literature. J Pediatr Nurs 2016; 31:330-41. [PMID: 26699441 DOI: 10.1016/j.pedn.2015.11.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 11/06/2015] [Accepted: 11/07/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED Critical illness in children is a life changing event for the child, their parents, caregivers and wider family. There is a need to design and evaluate models of care that aim to implement family-centred care to support more positive outcomes for critically ill children and their families. Due to a gap in knowledge on the impact of such models, the present review was conducted. ELIGIBILITY CRITERIA Primary research articles written in English that focused on children hospitalised for an acute, unexpected, sudden critical illness, such as that requiring an intensive care admission; and addressed the implementation of a model of care in a paediatric acute care hospital setting. SAMPLE Thirteen studies met the inclusion criteria. RESULTS The models of care implemented were associated with positive changes such as reduced parental anxiety and improved communication between parents/caregivers and health professionals. However, no model provided intervention throughout each phase of care to (or post) hospital discharge. CONCLUSIONS Models of care applying family-centred care principles targeting critically ill children and their families can create positive changes in care delivery for the family. However a model which provides continuity across the span of care is required. IMPLICATIONS There is need to describe how best to design, implement and sustain models of care for critically ill children and their families. The success of any intervention implementation will be dependent on the comprehensiveness of the strategy for implementation, the relevance to the context and setting, and engagement with key stakeholders.
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Affiliation(s)
- Kate Curtis
- Sydney Nursing School, The University of Sydney, Sydney, Australia; St George Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Kim Foster
- Sydney Nursing School, The University of Sydney, Sydney, Australia; Faculty of Health, University of Canberra, Canberra, Australia
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Connie Van
- Sydney Nursing School, The University of Sydney, Sydney, Australia.
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Lindly OJ, Zuckerman KE, Mistry KB. Clarifying the Predictive Value of Family-Centered Care and Shared Decision Making for Pediatric Healthcare Outcomes Using the Medical Expenditure Panel Survey. Health Serv Res 2016; 52:313-345. [PMID: 27072197 DOI: 10.1111/1475-6773.12488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To estimate (1) family-centered care (FCC) and shared decision-making (SDM) prevalence, and (2) associations of FCC and SDM (FCC/SDM) with health care outcomes among U.S. children. DATA SOURCE The Medical Expenditure Panel Survey Household Component (MEPS-HC), a nationally representative survey of the noninstitutionalized, civilian population. STUDY DESIGN Secondary analyses of prospectively collected data on 15,764 U.S. children were conducted to examine FCC/SDM prevalence in year 1 and associations of FCC/SDM in year 1 with health services utilization, medical expenditures, and unmet health care needs in year 2. DATA COLLECTION/EXTRACTION METHODS We combined four MEPS-HC longitudinal files from 2007 to 2011. PRINCIPAL FINDINGS FCC/SDM prevalence in year 1 varied from 38.6 to 93.7 percent, and it was lower for composites with more stringent scoring approaches. FCC/SDM composites with stringent scoring approaches in year 1 were associated with reduced unmet needs in year 2. FCC/SDM, across all year 1 composites, was not associated with health services utilization or medical expenditures in year 2. FCC/SDM year 1 subcomponents describing consensus building and mutual agreement were consistently associated with unmet health care needs in year 2. CONCLUSIONS FCC/SDM composites with stringent scoring approaches measuring consensus building and mutual agreement may have the greatest utility for pediatric health care quality improvement efforts.
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Affiliation(s)
- Olivia J Lindly
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR.,Division of General Pediatrics, Oregon Health & Science University, Portland, OR
| | | | - Kamila B Mistry
- Agency for Healthcare Research and Quality, Office of Extramural Research, Education, and Priority Populations, Rockville, MD
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Gallo KP, Hill LC, Hoagwood KE, Olin SCS. A Narrative Synthesis of the Components of and Evidence for Patient- and Family-Centered Care. Clin Pediatr (Phila) 2016; 55:333-46. [PMID: 26116351 PMCID: PMC5555419 DOI: 10.1177/0009922815591883] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
A narrative synthesis was conducted to determine typical patient- and family-centered care (PFCC) components and their link to outcomes in pediatric populations. 68 studies with PFCC interventions and experimental designs were included. Study features were synthesized based on 5 core PFCC components (i.e., education from the provider to the patient and/or family, information sharing from the family to the provider, social-emotional support, adapting care to match family background, and/or s decision-making) and 4 outcome categories (health status; the experience, knowledge, and attitudes of the patient/family; patient/family behavior; or provider behavior). The most common PFCC component was education; the least common was adapting care to family background. The presence of social-emotional support alone, as well as educational interventions augmented with shared decision-making, social-emotional support, or adaptations of care based on family background, predicted improvements in families' knowledge, attitudes, and experience. Interventions that targeted the family were associated with positive outcomes.
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Affiliation(s)
- Kaitlin P. Gallo
- The Child Study Center at NYU Langone Medical Center, New York, NY
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Foster M, Whitehead L, Maybee P. The Parents', Hospitalized Child's, and Health Care Providers' Perceptions and Experiences of Family-Centered Care Within a Pediatric Critical Care Setting: A Synthesis of Quantitative Research. JOURNAL OF FAMILY NURSING 2016; 22:6-73. [PMID: 26706128 DOI: 10.1177/1074840715618193] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Family-centered care (FCC) purports that unlimited presence and involvement of the family in the care of the hospitalized child will optimize the best outcome for the child, family, and institution. A systematic appraisal was conducted of peer-reviewed, English-language, primary quantitative research conducted within a pediatric critical care setting reported from 1998 to 2014. The aim of this review was to explore the parents', hospitalized child's, and health care providers' perception of FCC within pediatric critical care. Fifty-nine articles met the criteria that generated themes of stress, communication, and parents' and children's needs. This review highlighted that communication tailored to meet the parents' and child's needs is the key to facilitating FCC and positive health outcomes. Health care providers need to be available to provide clinical expertise and support throughout the health care journey. Future initiatives, education, and research are needed to evaluate the benefits of parent- and child-led FCC practice.
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Affiliation(s)
- Mandie Foster
- 1 University of Otago, Christchurch, New Zealand
- 2 Christchurch Hospital, New Zealand
| | - Lisa Whitehead
- 3 Edith Cowan University, Joondalup, Western Australia, Australia
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